Ventana software support forum

Andy Mather wrote:

>I am interesting in modelling hospital bed management in a publicly funded
>University hospital- with particular reference to resolving the difficulty
>of emergency patients accessing beds without disrupting the access for
>waiting list patients . Is there anyone who can point to any work in this
>area??
>

A hands-on non-computer simulation called "Friday Night at the ER" uses
this basic dynamic as its underlying structure. This simulation has been
used as a general introduction to the dynamic complexities of systems (like
the beer game created at MIT) and as an ice-breaker for health care
administrators who need to find practical solutions to problems like these
that move from finding who to blame, to creating new structures which
better serve the organizations purpose. The game is played and de-briefed
in about 3 hours. It was created by Bette Gardner. Many of my health
care clients have developed their own capacity to facilitate this
simulation because it is an effective tool to help staff better appreciate
their own situation, and the sticky context management faces in arriving at
solutions.

For more information contact:


Sue Woolsey, Operations Manager
Breakthrough Learning, Inc.
17800 Woodland Avenue
Morgan Hill, CA 95037

(408) 779-0701/ (408) 779-5158 (fax)


Sherry Immediato


Sherry Immediato, President (617)449-8909 sherry@world.std.com
Heaven & Earth Incorporated - enabling collective intelligence and wisdom
P.O. Box 381027 Cambridge, MA 02238-1027

>Aldo Zagonel asked with respect to "Friday Night at the ER"
>If this is a "non-computer" simulation, I am curious to know how it
>works? How is it "like the beer game?"

It works like a board game with players managing departments
(ER, Surgery, Critical Care, Step Down) in a hospital. The
system changes state each simulated hour with new events and
surprises. Decisions are made by department managers about
how to handle the events and surprises. The objective is for
the hospital to provide the best quality care at the lowest
cost.

Jeff Dooley
Adaptive Learning Design
Petaluma, CA 94952
707-762-1460
dooley@well.com
----------------------

>Aldo Zagonel asked with respect to "Friday Night at the ER"
>If this is a "non-computer" simulation, I am curious to know how it
>works? How is it "like the beer game?"


The makers of the game describe "Friday Night at the ER" this way:

The game is played in teams of four around large vinyl game boards. There
is no limit to the number of teams that can play at one time. Players each
"manage" one of four hospital departments during a simulated 24-hour
period. As the managers supervise patient flow through the facility, they
make decisions about resource use and operating policy. ... When the
simulation concludes, success is measured by both quality of service and
financial performance.

For those unfamiliar with the "Beer Game", the description of the most
common format is similar:

The game is played in teams of 4-8 (1 or 2 players per function) around
large vinyl game boards. Each board represents one beer company. Healthy
competition is facilitated by having at least 3 beer companies play at the
same time, although single teams can play against historical results.
Players each "manage" one of four production-distribution functions
(retailer, wholesaler, distributor, factory) during a simulated 1 year
period clocked in weekly increments. Each function is given the task of
managing its costs; costs are a function of inventory (carrying costs) and
order backlog (disgruntled customers, and ultimately lost orders). The
only decision players make is how much beer to order from their supplier
within the beer company. When the simulation concludes success is measured
by the cost position of each beer company. Each company is asked to graph
their performance in terms of inventory and backlog over the course of the
simulation, and the reveal their decision history (also graphically). This
information is posted and compared, and used to investigate what it is
about the underlying structure of the production distribution system that
influences the performance of all teams.

A further description of the beer game is available in Chapter 3 of The
Fifth Discipline by Peter Senge. An additional resource is a video tape
of a MacNeil-Lehrer NewsHour (PBS) clip featuring John Stermans MIT class
playing and discussing the game.

I hope this information helps those who have not played these games to have
a better feel for them.

Sherry

Sherry Immediato, President (617)449-8909 sherry@world.std.com
Heaven & Earth Incorporated - enabling collective intelligence and wisdom
P.O. Box 381027 Cambridge, MA 02238-1027

Aldo,

I would suggest you contact Bette Gardener, creator of Friday Night at
the ER board game to learn about the modified simulation underlying the
game. Her e-mail is: BTLng@aol.com. I have found it to be a
universally appealing springboard to introduce basic concepts such as
delays, the attractiveness principle, leverage points in complex
systems, time frames in decision making (short-term vs. long-term) and
the potential unintended consequences created by local optimization
(enhancing the performance of the Emergency Room) to the larger system
(the hospital).

Linda
boothli@MIT.EDU